Summer Staff Application
Please complete this form to be consider as a summer staff member.
Full Name
*
First Name
Last Name
Gender
*
Male
Female
Marital Status:
*
Single
Married
Birthday
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Please Upload A Recent Photo Of Your Self
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Parental Information
Father's Name
First Name
Last Name
Mother's Name
First Name
Last Name
Do your parents approve of you working at Camp Chetek
Yes
No
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College Information
College Status
Please Select
High School Student
High School Graduate
Freshman
Sophomore
Junior
Senior
College Graduate
Grad Student
College Major
College Name
College Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will your ministry at camp fulfill a course requirement for your college
True
False
Please Explain
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Pastoral Contact Information
Pastor's Name
*
First Name
Last Name
Pastor's Email
*
example@example.com
Pastor's Cell
*
Please enter a valid phone number.
Format: (000) 000-0000.
Church Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Church Name
Church Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Life and Testimony
Why do you feel God would have you minister at Camp Chetek
*
Character Strength
*
Character Weakness
*
Personal Testimony
*
Growth with Christ
*
Attitude Towards Church
*
Child abuse, child neglect, assault, etc.
*
Yes
No
Have you ever been convicted of any thing other than a traffic violation
*
Yes
No
Please Explain
Dismissed from college or high school or disciplined out of a local church
*
Yes
No
Please Explain
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Personal Information
Interest in Camp Chetek
Please Select
Definitely Want To Come
Strong Consideration
Somewhat Interested
Considering Several Options
Preferred Role or Department 1
*
Please Select
Camp Counselor
Kitchen Staff
Maintenance
Information Technology
Wrangler
Guy Counselor
T.E.A.M. Counselor
Videographer
Photographer
Health Services
Cook Staff
Office Assistant
Program Staff
Maintenance Assistant
Business Internship
Information Technolgy
Place Me Where Needed
Kid Wrangler
Other
Preferred Role or Department 2
*
Please Select
Camp Counselor
Kitchen Staff
Maintenance
Information Technology
Wrangler
Guy Counselor
T.E.A.M. Counselor
Videographer
Photographer
Health Services
Cook Staff
Office Assistant
Program Staff
Maintenance Assistant
Business Internship
Information Technolgy
Place Me Where Needed
Kid Wrangler
Other
Preferred Role or Department 3
*
Please Select
Camp Counselor
Kitchen Staff
Maintenance
Information Technology
Wrangler
Guy Counselor
T.E.A.M. Counselor
Videographer
Photographer
Health Services
Cook Staff
Office Assistant
Program Staff
Maintenance Assistant
Business Internship
Information Technolgy
Place Me Where Needed
Kid Wrangler
Other
If considering several ministry/employment options, please list them below
Who recommended Camp Chetek to you
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Certifications
Are you Certified in First Aid
*
Yes
No
Expires
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you a Certified Lifeguard
*
Yes
No
Expires
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
List any certifications that might be helpful at camp
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Health Information
Do you have any restrictions that would make it difficult for you to engage in any sport or activity included in a full camp schedule
Yes
No
Please Explain:
List any allergies or allergic reactions:
List any food allergies and sensitivities
Chronic Back Pain
Epilepsy
AIDS
Seizures
Fibromyalgia
Sleeping Disorder
Asthma
Hypoglycemia
Chronic Fatigue Syndrome
Cardiovascular Disorder
Carpal-tunnel
Tendinitis
Arthritis
Migraines
Mental Illness
Other medical issues or concerns
List reasons for medication
Emergency Contact Name
*
First Name
Last Name
Relationship to you
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Previous Camp Experience
Previous Positions
Previous Camps
Are you a past Camp Chetek camper
Yes
No
How many years
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